Kenneth John Sparks, LMSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

6801105565 Issued in MI

Practice address

540 Jenner Dr
Allegan, MI 49010-1517

Phone

(269) 673-6617

NPI assigned

Jan 7, 2019

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Allegan County Community Mental Health ServicesGroup PAC ID 1153317607, 25 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Allegan County Community Mental Health Services

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Allegan, MI
  • NPI 1215989231
  Medicare reassignment Care Compare group NPD
• Comstock Community Center

  • Adult Day Care Clinic/Center
  • Kalamazoo, MI
  • NPI 1558136531
  NPD (past) Authorized official
• Allegan County Community Mental Health Services

  • Primary Care Clinic/Center
  • Allegan, MI
  • NPI 1528570322
  NPD
• Hospice Care of Southwest Michigan

  • Community Based Hospice Care Agency
  • Kalamazoo, MI
  • NPI 1235197401
  NPD (past)
• Hospice Care of Southwest Michigan

  • Hospice and Palliative Medicine (Family Medicine) Physician
  • Portage, MI
  • NPI 1518681550
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1546819200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734393600000",
    "number": "1154894756",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "540 JENNER DR",
            "city": "ALLEGAN",
            "state": "MI",
            "postal_code": "490101517"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "540 JENNER DR",
            "city": "ALLEGAN",
            "state": "MI",
            "postal_code": "490101517",
            "telephone_number": "269-673-6617"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPARKS",
        "first_name": "KENNETH",
        "middle_name": "JOHN",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-01-07",
        "last_updated": "2024-12-17",
        "certification_date": "2024-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801105565",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LARA MICHIGAN",
            "identifier": "6801105565",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Hannah Lauren Smoot, PA
• Solutions Counseling Services
• South West Michigan Urology PLLC
• Southwest Mi Radiology PLLC
• Southwest Michigan Radiology PLLC
• Sara Jane Stahl, LMSW
• Laurissa Stawicki, LBSW
• Sterling Residential Services
• Victoria Stevens, BM, MT-BC
• Amy Lynn Steward, F.N.P.

• Clinical Social Worker in Allegan, MI
• Providers in Allegan, MI by specialty
• Clinical Social Worker in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.